Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma.

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Serval ID
serval:BIB_2F98A8407C41
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma.
Journal
Annals of Oncology
Author(s)
Weder W., Stahel R.A., Bernhard J., Bodis S., Vogt P., Ballabeni P., Lardinois D., Betticher D., Schmid R., Stupp R., Ris H.B., Jermann M., Mingrone W., Roth A.D., Spiliopoulos A. and 
ISSN
0923-7534
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
18
Number
7
Pages
1196-1202
Language
english
Abstract
BACKGROUND: The aim of this multicenter trial was to prospectively evaluate neo-adjuvant chemotherapy followed by extrapleural pneumonectomy (EPP) and radiotherapy, including quality of life as outcome. PATIENTS AND METHODS: Eligible patients had malignant pleural mesothelioma of all histological types, World Health Organization performance status of zero to two and clinical stage T1-T3, N0-2, M0 disease considered completely resectable. Neo-adjuvant chemotherapy consisted of three cycles of cisplatin and gemcitabine followed by EPP. Postoperative radiotherapy was considered for all patients. RESULTS: In all, 58 of 61 patients completed three cycles of neo-adjuvant chemotherapy. Forty-five patients (74%) underwent EPP and in 37 patients (61%) the resection was complete. Postoperative radiotherapy was initiated in 36 patients. The median survival of all patients was 19.8 months [95% confidence interval (CI) 14.6-24.5]. For the 45 patients undergoing EPP, the median survival was 23 months (95% CI 16.6-32.9). Psychological distress showed minor variations over time with distress above the cut-off score indicating no morbidity with 82% (N = 36) at baseline and 76% (N = 26) at 3 months after surgery (P = 0.5). CONCLUSIONS: The observed rate of operability is promising. A median survival of 23 months for patients undergoing EPP compares favourably with the survival reported from single center studies of upfront surgery. This approach was not associated with an increase in psychological distress.
Keywords
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Cisplatin, Combined Modality Therapy, Deoxycytidine, Female, Humans, Kaplan-Meiers Estimate, Male, Mesothelioma, Middle Aged, Neoadjuvant Therapy, Pleural Neoplasms, Pneumonectomy, Quality of Life, Radiotherapy
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2008 13:00
Last modification date
25/09/2019 6:08
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